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Last Modified: 8/18/2022 Location: FL, PR, USVI Business: Part A

Reject reason code C7010 FAQ

Q: We are receiving reject reason code C7010. What steps can we take to avoid this reason code?
Refer to the Part A reason code lookup for a description associated with the Medicare Part A reason code(s). Enter a valid reason code into the box and click the submit button.
A: You are receiving this reason code when the beneficiary was/is enrolled in a hospice election period for the date of service(s).
Confirm the beneficiary’s eligibility via direct data entry (DDE), interactive voice response (IVR) system, or Secure Provider Online Tool (the SPOT)
If the information is invalid
Contact the hospice provider and ask them to submit their last claim for the beneficiary with occurrence code 42 and the date of disenrollment. Once the records are deleted or updated, refile the claim to Medicare
If the information is valid and the services provided to the beneficiary are related to their terminal condition for hospice services
Refile the claim with the hospice provider listed on the beneficiary’s records
If the information is valid and the services provided to the beneficiary are not related to their terminal condition for hospice services
Refile the claim with a condition code 07 (treatment of non-terminal condition for hospice patient)
SPOT Users:
Visit the Check Eligibility page and search by date of service and beneficiary information.
On the Eligibility/Benefits results page, select the Hospice/Home Health tab (when available).
Hospice/Home Health tab
The beneficiary’s hospice results will include the following information:
Effective Date
Termination Date
Revocation Code:
0 = No revocation, open spell
1 = Revoked by beneficiary
2 = Revoked (occurrence code 42)
3 = Revoked (occurrence code 23)
Search the NPI Registry external link for the hospice provider’s contact information
Hospice Occurrence Count (when applicable)
SPOT Hospice Record
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.